BNCT of some benefit in recurrent head-and-neck cancer

Boron neutron capture therapy (BNCT) garners a good response in most patients with inoperable, locally advanced head-and-neck carcinoma that has recurred at a previously irradiated site—but cancer recurrence after this treatment remains frequent.

This was the conclusion of a small, prospective phase I/II trial of 30 patients in Finland who were administered BNCT, a biologically targeted treatment that uses boron-10 and thermal neutrons to produce radiation inside a tumor. The subjects had previously undergone surgery and conventionally fractionated photon irradiation administered with or without concomitant chemotherapy. Most (26 patients) received BNCT twice; the remaining four patients, once.

In total, 22 of the 29 evaluable participants (76%) responded to BNCT. The median progression-free survival time was 7.5 months, and 27% of the patients survived for 2 years without locoregional recurrence. The investigators deemed toxicity to be acceptable, with the most common acute grade 3 adverse effects being mucositis (54% of patients), oral pain (54%), and fatigue (32%). Three participants were diagnosed with grade 3 osteoradionecrosis and one with soft-tissue necrosis. Three of 15 evaluable patients experienced late grade 3 xerostomia.

As noted in the report—authored by Heikki Joensuu, MD, of Helsinki University Central Hospital's department of oncology, and colleagues, and published online by the International Journal of Radiation Oncology*Biology*Physics—several of the investigators have received financial compensation from study sponsor and BNCT provider Boneca Corporation for work done to treat BNCT patients. However, the company had no role in designing the study, in analyzing or interpreting the data, or in writing the report.